An mHealth Intervention to Improve Young Gay and Bisexual Men's Sexual, Behavioral, and Mental Health in a Structurally Stigmatizing National Context.
An mHealth Intervention to Improve Young Gay and Bisexual Men's Sexual, Behavioral, and Mental Health in a Structurally Stigmatizing National Context.
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DOI：
10.2196/mhealth.9283
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发表时间：
2018-11-14
影响因子：
5
通讯作者：
Pachankis JE
中科院分区：
文献类型：
--
作者：
Leluțiu-Weinberger C;Manu M;Ionescu F;Dogaru B;Kovacs T;Dorobănțescu C;Predescu M;Surace A;Pachankis JE
在一些东欧国家，如罗马尼亚，年轻的同性恋和双性恋男子（YGBM）面临着高度的耻辱和歧视，包括在医疗保健方面。由于预防不足、前往高流行率国家以及性网络技术的普及，艾滋病毒传播日益增加是一个令人关切的问题。本研究旨在适应和试点测试，在罗马尼亚，一个初步有效的移动的健康（mHealth）艾滋病毒预防干预，在美国创建，以减少艾滋病毒的风险YGBM。经过干预形成阶段后，我们招募了43名YGBM，平均年龄23.2（SD 3.6）岁，他们报告在过去3个月内与男性伴侣发生无安全套性行为并至少5天酗酒。这些YGBM完成了长达8个60分钟的基于文本的咨询课程，这些课程以动机访谈和认知行为技能培训为基础，由训练有素的顾问在私人研究移动的平台上进行。我们进行了一组干预前后的性（如艾滋病毒风险行为），行为（如酒精使用）和心理健康（如抑郁症）结果评估干预的影响。从基线到随访，参与者报告艾滋病毒相关知识显著增加（平均4.6 vs平均4.8; P=.001）和最近的艾滋病毒检测（平均2.8 vs平均3.3; P= 0.05）;（2）重度饮酒天数减少（平均12.8对平均6.9; P= 0.005）;（3）安全套使用的自我效能增加（平均3.3对平均4.0; P= 0.01）。参与者报告焦虑（平均1.4 vs平均1.0; P= 0.02）和抑郁（平均1.5 vs平均1.0; P= 0.003）显著减少。干预产生了高度的可接受性和可行性：86%（38/44）的参与者谁开始干预完成了最低剂量的5个会话，平均完成7.1个会话;评估访谈表明，参与是有益的，并“大开眼界”的艾滋病毒风险降低，健康的身份发展，和合作伙伴的沟通。这是东欧第一个针对青年男女的移动健康艾滋病毒风险降低试点干预措施，表明了初步的有效性和很强的可接受性和可行性。这种移动的预防工具适合在各种类似环境中广泛传播，等待未来在大型试验中进行功效测试，特别是在耻辱感使YGBM无法获得肯定性健康干预措施的情况下。
Young gay and bisexual men (YGBM) in some Eastern European countries, such as Romania, face high stigma and discrimination, including in health care. Increasing HIV transmission is a concern given inadequate prevention, travel to high-prevalence countries, and popularity of sexual networking technologies. This study aimed to adapt and pilot test, in Romania, a preliminarily efficacious mobile health (mHealth) HIV-prevention intervention, created in the United States, to reduce HIV risk among YGBM. After an intervention formative phase, we enrolled 43 YGBM, mean age 23.2 (SD 3.6) years, who reported condomless sex with a male partner and at least 5 days of heavy drinking in the past 3 months. These YGBM completed up to eight 60-minute text-based counseling sessions grounded in motivational interviewing and cognitive behavioral skills training with trained counselors on a private study mobile platform. We conducted one-group pre-post intervention assessments of sexual (eg, HIV-risk behavior), behavioral (eg, alcohol use), and mental health (eg, depression) outcomes to evaluate the intervention impact. From baseline to follow-up, participants reported significant (1) increases in HIV-related knowledge (mean 4.6 vs mean 4.8; P=.001) and recent HIV testing (mean 2.8 vs mean 3.3; P=.05); (2) reductions in the number of days of heavy alcohol consumption (mean 12.8 vs mean 6.9; P=.005), and (3) increases in the self-efficacy of condom use (mean 3.3 vs mean 4.0; P=.01). Participants reported significant reductions in anxiety (mean 1.4 vs mean 1.0; P=.02) and depression (mean 1.5 vs mean 1.0; P=.003). The intervention yielded high acceptability and feasibility: 86% (38/44) of participants who began the intervention completed the minimum dose of 5 sessions, with an average of 7.1 sessions completed; evaluation interviews indicated that participation was rewarding and an “eye-opener” about HIV risk reduction, healthy identity development, and partner communication. This first mHealth HIV risk-reduction pilot intervention for YGBM in Eastern Europe indicates preliminary efficacy and strong acceptability and feasibility. This mobile prevention tool lends itself to broad dissemination across various similar settings pending future efficacy testing in a large trial, especially in contexts where stigma keeps YGBM out of reach of affirmative health interventions.
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DOI：
10.1097/qai.0000000000001697
发表时间：
2018-08-01
影响因子：
3.6
作者：
Branstrom, Richard;Pachankis, John E.
通讯作者：
Pachankis, John E.
影响因子：
168.9
作者：
Beyrer, Chris;Sullivan, Patrick S.;Sanchez, Jorge;Dowdy, David;Altman, Dennis;Trapence, Gift;Collins, Chris;Katabira, Elly;Kazatchkine, Michel;Sidibe, Michel;Mayer, Kenneth H.
通讯作者：
Mayer, Kenneth H.
影响因子：
4.4
作者：
Ferrer, Laia;Furegato, Martina;Mirandola, Massimo
通讯作者：
Mirandola, Massimo
DOI：
10.15288/jsa.2000.61.413
发表时间：
2000-05-01
期刊：
JOURNAL OF STUDIES ON ALCOHOL
影响因子：
--
作者：
Cooper, ML;Orcutt, HK
通讯作者：
Orcutt, HK
影响因子：
12.7
作者：
Chesney, MA;Barrett, DC;Stall, R
通讯作者：
Stall, R